Leaflet information

Diclofenac for pain and inflammation

Diclofenac for pain and inflammation

This leaflet is about the use of diclofenac to reduce mild-to-moderate pain and inflammation. This might be after an injury, or due to a long-term condition such as juvenile arthritis.

This leaflet has been written specifically for parents and carers about the use of this medicine in children. The information may differ from that provided by the manufacturer. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again.

If your child is allergic to other drugs for inflammation or has asthma, check with your doctor before giving this medicine.

Name of drug

Why is it important for my child to take this medicine?

Diclofenac will help your child to feel less pain. It works best for inflammation and long-term pain when taken regularly for a few days.

What is diclofenac available as?

Tablets: 25 mg, 50 mg

Dispersible tablets: 10 mg (special order), 50 mg

Suppositories: 12.5 mg, 25 mg or 50 mg

When should I give diclofenac?

Diclofenac tablets are usually given three times a day. This should be first thing in the morning, early afternoon and at bedtime. Ideally, these times are at least 4 hours apart.

Suppositories are given twice a day. This should be one in the morning, and one at bedtime. Ideally these times should be 10–12 hours apart.

Your doctor will tell you how often to give diclofenac to your child.

How much should I give?

Your doctor will work out the amount of diclofenac (the dose) that is right for your child. The dose will be shown on the medicine label.

It is important that you follow your doctor’s instructions.

How should I give it?

Ideally, give diclofenac tablets to your child after a meal or some food, as it is less likely to upset their stomach. Avoid giving it on an empty stomach.

Tablets should be swallowed with a glass of water, juice or similar. Your child should not chew the tablet.

Dispersible tablets: You can dissolve the powder in water or fruit juice. Your doctor or pharmacist will have told you how much liquid to use, and how much to give your child. Make sure your child drinks it all straight away, using a medicine spoon or oral syringe.

Suppositories: A suppository is a plug of medicine designed to melt at body temperature within the rectum (back passage, or bottom). It must not be taken by mouth.

Ideally your child should open their bowel (do a poo) before you give a suppository.

Wash your hands with soap and hot water.

You can put on disposable plastic gloves before using suppositories. You can get these from a pharmacy. However, some people find it easier to have bare, clean hands.

Your child should be lying on their side or front.

Hold one buttock gently to one side so that you can see the rectum.

Unwrap the suppository and hold it with the rounded end close to the rectum.

Use one finger to push the suppository gently into the rectum. It needs to go in by about 2 cm. (You can use lubricating gel to make insertion more comfortable.)

Your child should stay lying on their side for about 15 minutes. This will allow the suppository to spread further inside the bowel and make sure it doesn’t come out.

Wash your hands again with soap and hot water.

If your child empties their bowels (does a poo) within 30 minutes of inserting a suppository, you will need to insert another one.

When should the medicine start working?

Your child should start to feel less pain within an hour of taking diclofenac.

If your child is taking diclofenac for inflammation, they will need to take it regularly for about 3 weeks for it to work properly. For arthritis, it may take up to 12 weeks for the full benefit to be felt.

What if my child is sick (vomits)?

Tablets

If your child is sick less than 30 minutes after having a dose of diclofenac, give them the same dose again.

If your child is sick more than 30 minutes after having a dose, you do not need to give another dose. Wait until the next normal dose.

If your child is sick again, seek advice from your GP, pharmacist or hospital. They will decide what to do based on your child’s condition and the specific medicine involved.

Suppository

If your child is sick at any time, you do not need to give them another dose, as the suppository will still work.

What if I forget to give it?

If your child is still in pain, give the missed dose as soon as you remember. You must then wait at least 6 hours before giving the next dose.

Never give a ‘double’ dose of diclofenac.

What if I give too much?

If you think you may have given your child an extra dose of diclofenac by mistake, wait at least 12 hours before giving another dose.

If your child may have had more than a double dose of diclofenac, or you are not sure, contact your doctor or local NHS services (111 in England and Scotland; 0845 4647 in Wales), or take your child to hospital straight away.

Take the medicine container or pack with you, even if it is empty. This will be useful to the doctor. Have the packet with you if you telephone for advice.

If your child has heart, kidney or liver disease, you must be particularly careful not to give too much diclofenac.

Are there any possible side-effects?

We use medicines to make our children better, but sometimes they cause effects that we don’t want (side-effects).

Side-effects that you must do something about

If your child gets bad stomach pain, brings up (vomits) blood or their stools (poo) are very dark, contact your doctor straight away or take your child to hospital. They may have an ulcer.

Other side-effects you need to know about

Diclofenac may cause stomach pain, indigestion and heartburn, and your child may feel sick or be sick (vomit). You can help to reduce this by giving diclofenac with food.

If these symptoms carry on, they may be signs of irritation to the stomach and oesophagus (food pipe). Contact your doctor if this happens.

Your child may get diarrhoea.

Diclofenac suppositories may irritate your child’s bottom.

There may, sometimes, be other side-effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side-effects to a UK safety scheme at http://www.mhra.gov.uk/yellowcard.

Can other common medicines be given at the same time as diclofenac?

Do not give your child medicines that contain ibuprofen.

You can give your child medicines that contain paracetamol, unless your doctor has told you not to.

Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal or complementary medicines.

Is there anything else I need to know about this medicine

Diclofenac is one of a group of drugs called ‘non-steroidal anti-inflammatory drugs’ (NSAIDs). If your child has previously reacted to other drugs of this type, you should tell your doctor before starting diclofenac.

Diclofenac can make asthma worse in some children, but this is very rare.

Diclofenac can cause stomach bleeding or an ulcer in the gut when taken regularly for long periods of time. Give diclofenac to your child with some food to help prevent this. Your doctor may prescribe an antacid, a medicine for indigestion, such as ranitidine [link].

Your child’s skin may become more sensitive to sunlight. Keep them out of strong sun, and use a high-factor sun block (at least SPF 15). It is particularly important to avoid sunburn. They should not go on a sun bed.

Your child should drink plenty of fluids, such as water, while they are taking this medicine. If your child becomes dehydrated (not enough water in the body), diclofenac may affect their kidneys. If you are concerned, contact your doctor or nurse .

General advice about medicines

If diclofenac does not seem to be helping your child’s pain, contact your doctor for advice.

Only give this medicine to your child. Never give it to anyone else, even if they seem to have the same condition, as you could do them harm.

If you think someone else may have taken diclofenac by accident, contact your doctor for advice.

Try to give the medicine at about the same times each day, to help you remember. Write down the times that you give doses.

Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.

Make sure that the medicine is not older than the ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.

Where should I keep this medicine?

Keep the medicine in a cupboard, away from heat and direct sunlight. It does not need to be kept in the fridge.

Make sure that children cannot see or reach the medicine.

Keep the medicine in the container it came in.

Where I should keep this medicine?

Keep the medicine in a cupboard, away from heat and direct sunlight. It does not need to be kept in the fridge.

Make sure that children cannot see or reach the medicine.

Keep the medicine in the container it came in.

Who to contact for more information

Your doctor, pharmacist or nurse will be able to give you more information about diclofenac and other medicines used to treat pain and inflammation.

The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk.

We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.